ObjectiveTo understand the advance in research of high risk factors and diagnosis in primary carci-noma of gallbladder. MethodsThe literatures at home and abroad during recent years were reviewed, and the research progress of high risk factors and inchoate diagnosis about primary gallbladder carcinoma were summarized. ResultsCholecystolithiasis, cholecystitis, and other factors have a certain correlation with primary gallbladder carcinoma.The rate of early diagnosis of primary gallbladder carcinoma can be enhanced through the detailed history taking and physical examination, supplemented by a variety of imaging examination methods, and molecular biological technologies. ConclusionIt can enhance the rate of early diagnosis of primary gallbladder carcinoma that understand the risk factors and master various methods for early diagnosis of carcinoma of gallbladder.
ObjectiveTo evaluate the postoperative complications after pancreaticoduodenectomy with modified triple-layer(MTL) duct-to-mucosa pancreaticojejunostomy and with resection of jejunal serosa, analyse the risk factors of pancreatic fistula, and compare effects with two-layer(TL) duct-to-mucosa pancreaticojejunostomy. MethodsData on 184 consecutive patients who underwent the two methods of pancreaticojejunostomy during standard PD between January 1, 2010 and January 31, 2013 were collected retrospectively. The risk factors of pancreatic fistula were investigated by using univariate and multivariate analyses. ResultsA total of 88 patients received TL and 96 underwent MTL. Rate of pancreatic fistula for the entire cohort was 8.2%(15/184). There were 11 fistulas(12.5%) in the TL group and four fistulas(4.2%) in the MTL group(P=0.039). Body mass index, pancreatic texture, pancreatic duct diameter, and methods of pancreaticojejunostomy had significant effects on the formation of pancreatic fistula on univariate analysis. Multivariate analysis showed that pancreatic duct diameter less than 3 mm and TL were the significant risk factors of pancreatic fistula. ConclusionsMTL technique effectively reduced the pancreatic fistula rate after PD in comparison with TL, especially in patients with pancreatic duct diameter less than 3 mm.